title: Hood nebulization: effects of head direction and breathing mode on particle inhalability and deposition in a 7-month-old infant model.
abstract: BACKGROUND
  Aerosol drug delivery to infants is a strong function of their behavior. Infants can be active during medication administration, changing head position or breathing mode. The objective was to evaluate the influence of the head direction and breathing mode on the hood drug delivery in a 7-month-old girl airway model by using an approach that couples imaging with computational fluid dynamics (CFD). Three head directions, i.e., face up, face side, and sitting (face front), and two breathing modes, i.e., oronasal and nasal breathing, were studied.
  
  
  METHODS
  The face-airway model was developed from computed tomography scans of a 7-month-old girl. Respiratory airflows and particle transport were simulated with the low Reynolds number κ-ω turbulence model and Lagrangian tracking approach. Three pharmaceutical aerosol sizes (1, 2.5, and 5 μm) via hood nebulization were considered under quiet breathing conditions (5 L/min).
  
  
  RESULTS
  Both head direction and breathing mode can noticeably affect aerosol inhalability and lung delivery efficiency. A maximum of 20% difference in inhalability is observed among the three head positions. Facial-ocular depositions are predominantly influenced by head position, but not breathing mode. The facial-ocular deposition rate with the face-up position is about threefold that with the sitting position for 5-μm particles. Nasal breathing gives about 17.8% lower lung deposition and about 65% higher facial-ocular deposition than the oronasal breathing.
  
  
  CONCLUSIONS
  The face-side position has less facial-ocular deposition than the face-up position, while still achieving similar lung delivery efficiency. Because aerosols deposited around the eyes may cause irritation to the eyes, the face-side position appears to be a better option than the face-up position for comfort and safety reasons.
authors.affiliation: 1 Department of Mechanical and Biomedical Engineering, Central Michigan University , Mount Pleasant, MI 48858.
authors.forename: JongWon
authors.initials: J
authors.lastname: Kim
authors.forename: Jinxiang
authors.initials: J
authors.lastname: Xi
authors.forename: Xiuhua
authors.initials: X
authors.lastname: Si
authors.forename: Ariel
authors.initials: A
authors.lastname: Berlinski
authors.forename: Wei Chung
authors.initials: WC
authors.lastname: Su
mesh_terms: D000280:Administration, Inhalation; D000336:Aerosols; D003198:Computer Simulation; D016503:Drug Delivery Systems / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006257:Head / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D019416:Head Movements; D006801:Humans; D007223:Infant; D008953:Models, Anatomic; D009038:Motion; D009330:Nebulizers and Vaporizers; D009716:Numerical Analysis, Computer-Assisted; D010316:Particle Size; D004364:Pharmaceutical Preparations / Q000008:administration & dosage* / Q000737:chemistry; D011859:Radiography; D012119:Respiration; D012137:Respiratory System / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D012212:Rheology
chemical_list: D000336:Aerosols; D004364:Pharmaceutical Preparations
keywords: Hood nebulization; aerosol drug delivery; aerosol inhalability; facial deposition; imaging-CFD modeling; infant